Active NPI
Amanda Raquel Medina Padilla
- Pediatric Pathology Physician
- Charlottesvle, VA
National Provider Identifier
1952932980
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Pathology Physician
- License
- 2204000372
- Practice address
- 813 Exeter CT
Charlottesvle, VA 22901-1761 - Phone
- (787) 955-7401
- NPI assigned
- Jan 29, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Pathology Physician | 207ZP0213X | 2204000372 | VA | Primary |
Addresses
Primary practice location
813 Exeter CT
Charlottesvle, VA 22901-1761
Mailing address
PO Box 1140
Stanardsville, VA 22973-1140
Phone (434) 939-9002
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2204000372 | VA | MD | Pediatric Pathology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1580256000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1580256000000",
"number": "1952932980",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1140",
"city": "STANARDSVILLE",
"state": "VA",
"postal_code": "229731140",
"telephone_number": "434-939-9002"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "813 EXETER CT",
"city": "CHARLOTTESVLE",
"state": "VA",
"postal_code": "229011761",
"telephone_number": "787-955-7401"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEDINA PADILLA",
"first_name": "AMANDA",
"middle_name": "RAQUEL",
"name_prefix": "Miss",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-01-29",
"last_updated": "2020-01-29",
"certification_date": "2020-01-29",
"status": "A"
},
"taxonomies": [
{
"code": "207ZP0213X",
"taxonomy_group": "",
"desc": "Pathology, Pediatric Pathology",
"state": "VA",
"license": "2204000372",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Charlottesvle, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.